e Health initiatives for screening and management of hypertension in Rural Rajasthan

CONTEXT: Electronic health (e health) initiatives are being employed in various health programs for disease monitoring. Very few such studies have been conducted in India, so this study was planned. AIMS: Assess feasibility and usefulness of e health interventions for health workers, ASHA (accredited social health activist) in screening and management of hypertension. SETTING AND DESIGN: Prospective observational cohort study. ASHA's were recruited in two selected villages of Rajasthan and trained to use this technology. METHODS AND MATERIAL: A web-based application was developed for use on portable device (tablet) to screen and diagnose hypertension, provide health education focused on diet, physical exercise and promote adherence to therapies by repeated sessions of one-to-one health education. Statistical analysis was done by Excel. RESULTS: With the use of e health initiatives, among population above 18yrs, we found 19.1% hypertensives (464/2430) with 46.5% new cases of hypertension and 38.9 % (945/2430) prehypertensive. Mean age of hypertensives was 52.6 yrs. ± 15.2 and 36.8 yrs. ± 14.2 for prehypertensive and highly significant (p < 0.001). Mean systolic blood pressure level of hypertensives decreased from 147.14 Hg ±13.86 to 133.3 Hg ±13.07 and for prehypertensive from 123.18 mm Hg ± 4.5 to 117.55 mm Hg ± 6.9 after follow up, the difference in change was highly significant (P < 0.001). Also, could start 27.4% hypertensives on treatment, while 50.2% were already on treatment. CONCLUSION: Training ASHA worker in e health technology is feasible and can assist in screening and management of diseases.